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https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#1
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29778340/prospective-randomized-controlled-trial-of-polymer-cable-ties-versus-standard-wire-closure-of-midline-sternotomy
#2
Silvana F Marasco, Louise Fuller, Adam Zimmet, David McGiffin, Michael Seitz, Stephanie Ch'ng, Shivanand Gangahanumaiah, Michael Bailey
OBJECTIVE: Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. METHODS: A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60)...
April 16, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29698662/liberal-use-of-delayed-sternal-closure-in-children-is-not-associated-with-increased-morbidity
#3
S Ram Kumar, Nigel Scott, Winfield J Wells, Vaughn A Starnes
BACKGROUND: Delayed sternal closure (DSC) is often employed to optimize hemodynamics following pediatric cardiac surgery. Prior reports have suggested that DSC may be associated with increased morbidity. We sought to analyze the impact of a liberal policy of DSC on surgical outcomes at our center. METHODS: We retrospectively evaluated the clinical course of 1,000 consecutive patients between July 2005 and June 2015 whose sternum was electively left open following pediatric cardiac surgery...
April 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29656810/the-optimal-sternal-closure-technique-still-elusive
#4
EDITORIAL
Nirmal Veeramachaneni
No abstract text is available yet for this article.
March 16, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29623205/near-fatal-kinking-of-mammary-graft-due-to-emphysematous-lung-disease
#5
John T Denny, Sagar Mungekar, Benjamin R Landgraf, Valerie A McRae, Sajjad Ibrar, Geza K Kiss, Joyce Bonitz, Shaul Cohen, James T Tse
Left internal mammary artery grafting is commonly used in elective coronary artery bypass graft surgery. We report a near-fatal case with graft kinking upon sternal closure due to distended, emphysematous lungs impinging on the mammary graft. After the sternum was closed, the patient suffered a severe hemodynamic deterioration. Surgical examination revealed kinking of his left internal mammary artery upon sternal closure due to distended, emphysematous lungs impinging on the mammary graft. Using an off-bypass technique, the kink in the mammary graft to the left anterior descending artery was removed by moving the origin of the left internal mammary artery to a hooded graft of a saphenous vein graft instead...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29596821/intraoperative-device-closure-of-isolated-ventricular-septal-defects-experience-on-1090-cases
#6
Qiang Chen, Zhi-Nuan Hong, Gui-Can Zhang, Liang-Wan Chen, Qi-Liang Zhang, Ze-Wei Lin, Hua Cao
BACKGROUND: This study aims at summarizing the clinical experiences and 8-year follow-up results of the intraoperative device closure of ventricular septal defects. METHODS: From January 2009 to June 2017, 1090 patients with isolated ventricular septal defects (VSD) were enrolled in our institute to participate in the study. The procedure involved a small lower sternal incision that was performed after full evaluation of VSD by transesophageal/transthoracic echocardiographic (TEE/TTE) guidance and the deployment of a domestically made occluder to close the VSD through the periventricular way and off cardiopulmonary bypass...
March 26, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29577921/rigid-plate-fixation-versus-wire-cerclage-for-sternotomy-after-cardiac-surgery-a-meta-analysis
#7
REVIEW
Derrick Y Tam, Rashmi Nedadur, Monica Yu, Bobby Yanagawa, Stephen E Fremes, Jan O Friedrich
BACKGROUND: Traditionally, wire cerclage (WC) has been used to reapproximate the sternum after sternotomy. Recent evidence suggests that rigid plate fixation (RPF) for sternal closure may reduce the risk of sternal complications. METHODS: MEDLINE and EMBASE databases searched from inception to February 2017 for studies that compared RPF to WC in cardiac surgery patients undergoing sternotomy. Random-effects meta-analysis compared rates of sternal complications (primary outcome, defined as deep or superficial sternal wound infection, or sternal instability), early mortality, and length of stay (secondary outcomes)...
March 22, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29563372/the-effect-of-ultrasound-assisted-debridement-combined-with-vacuum-pump-therapy-in-deep-sternal-wound-infections
#8
Lachmandath Tewarie, Nikolay Chernigov, Andreas Goetzenich, Ajay Moza, Rüdiger Autschbach, Rashad Zayat
PURPOSE: To assess whether a combined treatment of low-frequency (25 kHz) ultrasonic-debridement systems followed by vacuum-assisted wound closure (VAC) produces a better outcome in deep sternal wound infections (SWIs) compared to that of VAC alone. METHODS: We evaluated 45 consecutive patients (25 males) between January 2013 and December 2016, in whom deep SWI was treated with a combination of low-frequency ultrasonic debridement system followed by vacuum-assisted closure (group A, n = 23) or with only vacuum-assisted closure therapy (group B, n = 22)...
March 22, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29549520/sternal-semi-closure-using-a-bioresorbable-osteosynthesis-device-a-new-method-for-delayed-sternal-closure
#9
Yuki Tanaka, Takashi Miyamoto, Yuji Naito, Shuichi Yoshitake, Akihiro Sasahara, Kagami Miyaji
PURPOSE: To evaluate the safety and efficacy of our new delayed sternal closure (DSC) method, involving sternal semi-closure using a bioresorbable osteosynthesis device and complete skin closure. METHODS: Between 2013 and 2017, 36 patients underwent DCS at our hospital. The patients were divided into two groups based on the method used for DSC. The later conventional DSC group consisted of 18 patients undergoing late complete sternal closure following fixation of pulmonary and hemodynamic instability, and the new DSC group consisted of 18 patients undergoing early sternal semi-closure a few days after surgery...
March 16, 2018: Surgery Today
https://www.readbyqxmd.com/read/29548913/zipfix-versus-conventional-sternal-closure-one-year-follow-up
#10
Pouya Nezafati, Ali Shomali, Mahdi Kahrom, Sahar Omidvar Tehrani, Minoo Dianatkhah, Mohammad Hassan Nezafati
BACKGROUND: The present study aimed to compare postoperative complications commonly revealed after sternotomy closure by new sternal ZipFix™ (Synthes GmbH, Oberdorf, Switzerland) implant and conventional steel wire. METHODS: Among the initial 360 subjects, 326 patients enrolled in this randomised control trial who were candidates for cardiac surgery from April 2014 to March 2015. After the surgery, the sternal closure was randomly done with poly-ether-ether-ketone (PEEK) based sternal ZipFix (ZF) on the sternal body (n=168) or with conventional wires (CWs) (n=158)...
February 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29536456/the-costa-study-sternal-closure-in-high-risk-patients-a-prospective-randomized-multicenter-trial
#11
Tetyana Leinberger, Claudia Heilmann, Stefan Sorg, Matthias Mueller, Sami Kueri, Claudia Schmoor, Matthias Siepe, Friedhelm Beyersdorf
BACKGROUND:  Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability. METHODS:  A total of 338 patients with elective first median sternotomy and at least four predefined risk factors were randomized between Sternal Talon (Gebrüder Martin GmbH & Co. KG-KLS Martin Group, Tuttlingen, Germany) and wire cerclage. The primary end point was mediastinitis and/or sternal instability within 30 ± 5 days, and the secondary end points were mediastinitis and/or sternal instability within 60 ± 5 days; incidence of pneumonia during hospitalization within the first 30 (±5) days and chest pain intensity...
February 2, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29534417/-end-to-side-anastomosis-for-interrupted-aortic-arch-in-neonates-and-infants
#12
M H Zou, L Ma, Y S Xia, S C Yang, W D Chen, F Cao, X X Chen
Objective: To review the early and mid-term results of end-to-side anastomosis technique for interrupted aortic arch in neonates and infants. Methods: Clinic data of 46 patients were diagnosed as interrupted aortic arch in Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center between January 2010 and December 2016 were analyzed retrospectively. Twenty-six cases were neonates. The median age underwent surgery was 23 days (range: 2 days to 8 years). Anatomical subtypes included 36 cases of type A and 10 cases of type B...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29462049/suprasternal-transcatheter-aortic-valve-replacement-in-patients-with-marginal-femoral-access
#13
Andy C Kiser, Thomas G Caranasos, Mark D Peterson, David M Holzhey, Philipp Kiefer, L Wiley Nifong, Michael A Borger
OBJECTIVE: Recently, the PARTNER 2A trial reported results of transcatheter aortic valve replacement versus surgical aortic valve replacement in 2032 intermediate-risk patients at 2 years. Two hundred thirty-six patients (24%) required an access route other than transfemoral. Compared with transfemoral and surgical aortic valve replacement, nontransfemoral transcatheter aortic valve replacement was associated with a numerically higher rate of death and disabling stroke at 30 days. This underscores the need for a better alternative surgical approach for patients with marginal femoral access...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29430829/the-two-bridges-technique-for-sternal-wound-closure-the-use-of-vacuum-assisted-closure-for-the-treatment-of-deep-sternal-wound-defects-a-centre-specific-technique
#14
Karl Waked, Philippe Ballaux, Dominique Goossens, Koen Cathenis
The objective is to describe the 'Two Bridges Technique' (TBT), which has proven to be successful and has been the standard technique at our centre for vacuum-assisted closure (VAC) of post-sternotomy mediastinitis. An extensive literature search was performed in four databases to identify all published articles concerning VAC for post-sternotomy mediastinitis. Several VAC methods have been used; however, no article has described our specific technique. TBT consists of a two-bridges construction using two types of foam with different pore sizes, which ensures an equally divided negative pressure over the wound bed and stabilisation of the chest...
April 2018: International Wound Journal
https://www.readbyqxmd.com/read/29422283/minimally-invasive-determinations-of-oxygen-delivery-and-consumption-in-cardiac-surgery-an-observational-study
#15
David T M Burtman, Annick Stolze, Selma E Kaffka Genaamd Dengler, Alexander B A Vonk, Christa Boer
OBJECTIVE: Evaluate minimally invasive assessment of oxygen delivery (DO2 ) and oxygen consumption (VO2 ) and determine its level of agreement with the gold standard approach of those measurements in patients undergoing cardiac surgery. DESIGN: Observational study. SETTING: Single center, VU University Medical Center (Amsterdam, The Netherlands). PARTICIPANTS: The study comprised 29 adult patients. INTERVENTION: Parallel measurements of invasive and minimally invasive parameters required for the calculation of DO2 and VO2 ...
June 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29408725/assessment-of-adulthood-in-the-living-spanish-population-based-on-ossification-of-the-medial-clavicle-epiphysis-using-ultrasound-methods
#16
María Benito, Alexandra Muñoz, Isabel Beltrán, Elena Labajo, Bernardo Perea, José Antonio Sánchez
It is a fact that in recent years requests have greatly increased to obtain estimates of the legal age of undocumented individuals alleged to be minors who have been forced to enter different European Community countries for socioeconomic reasons or due to war. Spain is one of the countries most affected by this illegal immigration because of its proximity to North Africa. Therefore, it has become necessary to develop new standards which help provide a response to the demands of the justice administration. In recent years, the Superior Justice Court has rejected several pieces of expert evidence on the grounds that the age intervals therein were not sufficiently reliable and that the radiographic techniques used to determine age were invasive, potentially causing harm to the alleged minor...
March 2018: Forensic Science International
https://www.readbyqxmd.com/read/29397934/impact-of-prothrombin-complex-concentrate-on-blood-use-cost-and-outcomes-in-heart-transplantation
#17
Ding Wen Wu, Yu Xia, Joan Uelinger, Stephen Forest, James Szymanski, Kala Mohandas, Ronald Walsh, Sadiqa Karim, Etan Marks, Evan Himchak, Ritu Gupta, Daniel Goldstein
BACKGROUND: Left ventricular assist device (LVAD) recipients undergoing heart transplantation have increased bleeding risk. We compared conventional warfarin reversal with fresh frozen plasma vs 4-factor prothrombin complex concentrate (PCC) and the effect on transfusion requirements, blood bank costs, and clinical outcomes. METHODS: A retrospective review identified 60 consecutive LVAD recipients undergoing heart transplantation divided into two groups: 30 (no PCC) received fresh frozen plasma and 30 (PCC) received PCC...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29390594/hybrid-repair-of-pectus-excavatum-and-congenital-heart-disease-a-case-report
#18
Xicheng Deng, Peng Huang, Liwen Yi, Xiaohui Yang, Cheng He
RATIONALE: Pectus excavatum (PE) in the setting of congenital heart disease is not uncommon. The surgical strategy has evolved over the last 20 years from a staged approach to simultaneous repair of both defects. PATIENT CONCERNS: A 3-year-old boy was admitted for elective repair of PE and atrial septal defect (ASD). DIAGNOSES: Clinically, there were obvious features of PE and a grade 2 systolic murmur heard loudest at the 2nd intercostal space abutting the left sternal border...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29337126/rigid-plate-fixation-versus-wire-cerclage-patient-reported-and-economic-outcomes-from-a-randomized-trial
#19
Keith B Allen, Vinod H Thourani, Yoshifumi Naka, Kendra J Grubb, John Grehan, Nirav Patel, T Sloane Guy, Kevin Landolfo, Marc Gerdisch, Mark Bonnell, David J Cohen
BACKGROUND: In a multicenter randomized trial, sternal closure after cardiac operations using rigid plate fixation (RPF) compared with wire cerclage (WC) resulted in improved sternal healing, reduced sternal complications, and was cost neutral at 6 months. Additional secondary end points are presented from this trial. METHODS: Twelve United States centers randomized 236 patients to RPF (n = 116) or WC (n = 120). Patient-reported outcomes measures, including pain, function, and quality of life scores, were assessed through 6 months and correlated to computed tomography-derived sternal healing scores using logistic regression...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29337124/evaluation-of-prophylactic-antibiotic-use-for-delayed-sternal-closure-after-cardiothoracic-operation
#20
Jamie L Eckardt, Matthew R Wanek, Chiedozie I Udeh, Elizabeth A Neuner, Thomas G Fraser, Tamer Attia, Eric E Roselli
BACKGROUND: Clinical practice guidelines provide recommendations for surgical prophylaxis in patients undergoing cardiothoracic procedures. However, currently no recommendations guide the management of antibiotic prophylaxis in patients who require delayed sternal closure after cardiothoracic operation. METHODS: This is a single-center, retrospective analysis. Data were extracted from The Society of Thoracic Surgery database and electronic medical record from July 2011 through January 2016...
January 12, 2018: Annals of Thoracic Surgery
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